How often have you heard that "beauty is only skin-deep" or "beauty is in the eye of the beholder?" Probably more times than you can count.

But one of the world's most famously beautiful women, Sophia Loren, offered an entirely different definition: "Beauty is how you feel inside."

At Washington Hospital, we're inclined to agree with the lovely Ms. Loren. After all, when you are healthy and feeling good about yourself, it's reflected in your appearance. When you're in pain or under stress, people can see that in your face and demeanor, too. That's why the Washington Women's Center has titled the 5th Annual Women's Health Conference, scheduled for Saturday, January 22, "Embrace Health: Feeling and Looking Your Best."

Keynote Address on Pain Management

One of the key issues affecting women's health - and appearance - is chronic pain, so the conference will feature a keynote address on "Chronic Pain Management" by Dr. Desmond Erasmus, a neurosurgeon and Director of the Spine Surgery Program at Washington Hospital.

"Women are somewhat more prone than men to experience chronic pain, which is generally defined as pain that persists for more than three months," Dr. Erasmus notes. "While chronic pain from injuries to the spine or limbs can affect both men and women equally, chronic pain from fibromyalgia is up to four times more common in women."

In his presentation, Dr. Erasmus will focus primarily on non-medicinal and non-surgical pain management techniques that women can use to reduce and manage chronic pain.

"Surgery and pain medications certainly can play an important role in chronic pain treatment, but there are a number of simple things women can do on their own to manage their pain," he says. "In many cases, physical exercise may restore the body's proper levels of seratonin and dopamine without pharmacological intervention, although some patients also may benefit from anti-depressants."

Chronic pain also can deplete the body's levels of endorphins - protein molecules surrounding the nerve cells that block pain.

"In a number of cases, a diet that is higher in protein - combined with exercise - may help control chronic pain," Dr. Erasmus says. "In addition, exercise and a diet with ample calcium can be useful in preventing osteoporosis, which can result in chronic pain due to compression and fractures of the spine. Osteoporosis also can be a painful condition even without fractures or spine compression."

Breakout Sessions on Pain Management

To supplement the keynote address by Dr. Erasmus, the conference will feature additional break-out sessions that focus on pain management: "Neck and Back Pain," presented by neurosurgeon Dr. Jasbir (Jenny) Multani, and "Pain and Rehabilitation," presented by a specialist in physical medicine and rehabilitation, Dr. Robert Miller.

"The traditional approach to pain management often revolves around surgery and pain medications such as anti-inflammatories, steroids and opiates," says. Dr. Miller. "In physical medication and rehabilitation - also known as physiatry - we take a common-sense approach using current physiatric principles that have been proven with scientific, peer-reviewed research."

Physiatrists such as Dr. Miller design various therapy protocols that physical therapists can use with patients to help manage chronic pain.

"For example, we might use a lower-back exercise machine such as the Med-X or the Texas Back Machine that targets lower back muscles to strengthen them, thus decreasing deep, achy lower back pain," he explains. "We also employ various other modalities to provide temporary pain relief, reduce nerve terminal firings that send out pain signals, and increase or decrease blood circulation as appropriate."

Some of the modalities used to accomplish the goals mentioned above may include application of heat or ice, electric stimulation and ultrasound. The physiatrist often coordinates pain management treatment with other specialists, including orthopedic surgeons and neurosurgeons, as well as physical therapists.

"We also work with chiropractors and acupuncturists if appropriate," Dr. Miller notes. "Successful chiropractic treatment is usually seen as a 50 percent decrease in pain within six to eight visits, lasting at least 30 to 40 days after the last treatment. The National Institutes of Health notes that 'successful' acupuncture treatment means a 30 to 50 percent decrease in pain after six treatments. It's important to get a referral from your doctor to a qualified chiropractor or acupuncturist."

Dr. Miller adds that he also uses pain medications, but does so in the context of functional therapy. "Medications are used to reduce pain while strengthening the body, gradually weaning the patient off medications," he says. "Some examples might include steroid injections, 'trigger-point' injections of lidocaine to break up deep muscle knots in the upper back and neck, and - more recently - Botox injections to treat myofascial muscle pain. We also can prescribe creams and patches containing mild forms of lidocaine. We do not recommend over-the-counter creams and patches, though. They simply do not work."

Participants will be able to choose two breakout lecture sessions featuring the following expert speakers:

To register for the upcoming Women's Health Conference, please call (800) 963-7070 and choose two morning sessions. The $10 fee to attend the conference can be paid at the door. No walk-ins. Space is limited and registration is required.